HomeMy WebLinkAboutRS042141_Park fee receipt (PM89-3)CENTRAL OFFICE
300 N. FLOWER ST.
SANTA ANA, CA 92703
714-834-2626
RECEI VED OF
PAYER:
PAYER'S
ADDRESS:
JOB OWNER
COUNTY OF ORANGE
FEE RECEIPT FORM
REGIONAL -OFFICE -
22921 TRITON WAY
LAGUNA HILLS. CA 9M3
949-472-7979
PAYER'S
TELEPHONE I
CITY ZIP
TRACT NO.
OWNER'S ADDRESS:
JOB ADDRESS:.4C4,1,.f
LOCAL PARK FEE REQUIRED FOR:
SINGLE-FAMILY DWELLING � MULTI -FAMILY DWCLLING CAA*
CENSUS TRACT AP %%
LOCAL PARK FEES DETERMINED OR MODIFIED SY. /_T 1
OTHER (/DATE
Codes: SO `+ Am'ts
TELLER DATE
F0250-189,9 (R210Z
RECEIPT FOR AMOUNT
TRUST FUND
IChecp No i
PLAN CHECK FEE
IType)
GRADING PRE -INSPECTION. FEE
LOCAL PARK FEE
ADDN,-At TERATION TO
PERMIT
IT peI (NumpN]
® e `
❑COUNTY PROPERTY
ENCROACHMENT PERMIT
_ VOLUME FACTOR
COST INOEII
TOTAL FEE
'REFER TO ��/ VERIFIE
BUILDING `( BY:
PERMIT (Number) I
FEE
"INSPECTOR J°